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Return to play following injury: Whose decision should it be?

机译:受伤后恢复比赛:应该由谁决定?

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Background Return-to-play (RTP) decision-making is required for every injured athlete. However, these decisions often lead to conflict between sport medicine professionals, athletes, coaches and sport associations. This study explores differences in professionals' opinion about which criteria should be used for RTP decisions, and who is best able to evaluate them. Methods We surveyed Canadian sport medicine physicians, physiotherapists, athletic therapists, chiropractors, massage therapists, athletes, coaches and representatives from three sport associations. The 10 min online survey asked respondents to rate criteria as mandatory to irrelevant on a five-point Likert scale, and to indicate which profession was best able to evaluate the criteria. Results In general, medical doctors, physiotherapists and athletic therapists were considered best able to assess factors related to risk of injury and complications from injury. Each clinician group (except sport massage therapists) generally believed their own profession has the best capacity to evaluate the criteria. Athletes, coaches and sport associations were considered to have the best capacity to assess factors related to competition (desire, psychological and financial impact and loss of competitive standing). There remained considerable heterogeneity both between and within stakeholder groups. Conclusions We found that differences in approach to RTP decisions were generally greater within versus between-stakeholder groups. If shared decision-making is to become the norm in clinical sport medicine, we need to begin a discussion on which discrepancies are due to lack of training (resolved through education) or scientific knowledge (resolved through research) or simply reflect the divergence of personal/societal values.
机译:背景每位受伤的运动员都需要做出重返比赛(RTP)的决策。但是,这些决定通常会导致运动医学专业人士,运动员,教练和体育协会之间发生冲突。这项研究探讨了专业人士关于哪些标准应用于RTP决策以及谁最有能力评估它们的意见上的差异。方法我们调查了加拿大运动医学医师,物理治疗师,运动治疗师,脊医,按摩治疗师,运动员,教练和三个体育协会的代表。这项10分钟的在线调查要求受访者将标准评定为与五分李克特量表无关的强制性标准,并指出哪个行业最有能力评估标准。结果通常,认为医生,物理治疗师和运动治疗师最能评估与受伤风险和受伤并发症相关的因素。每个临床医生组(运动按摩治疗师除外)通常都认为自己的专业具有评估标准的最佳能力。运动员,教练和体育协会被认为具有评估与比赛有关的因素(欲望,心理和财务影响以及失去竞争地位的能力)的最佳能力。利益相关者群体之间和内部之间仍然存在相当大的异质性。结论我们发现,在利益相关者群体之间,RTP决策方法的差异通常更大。如果要使共同的决策成为临床运动医学的常态,我们需要开始讨论哪些差异是由于缺乏培训(通过教育解决)或科学知识(通过研究解决)引起的,还是仅反映个人差异/社会价值。

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